目的探讨腹部穿透伤手术时机的选择。方法回顾性分析我院 1990年 1月～ 1999年 5月收治的 76例腹部穿透伤患者的症状、体征和手术所见 ;重点分析 2 8例手术阴性探查的病例特点。结果行急诊手术 74例 ,非手术治疗 2例。阳性探查 46例 ,占 6 2 .2 % ,阴性探查 2 8例 ,占 37.8%。结论呕血、便血、呼吸困难、伤口有胆汁或肠液流出、弥漫性腹膜炎和休克提示有腹腔脏器损伤 ,需要急诊手术探查。腹壁被穿透、大网膜或部分小肠脱出不是急诊手术探查的绝对适应症 Objective To explore the timing of abdominal penetrating injury surgery. Methods A retrospective analysis of our hospital from January 1990 to May 1999 admitted to the 76 cases of abdominal trauma patients with symptoms, signs and surgical findings; focusing on analysis of 28 cases of negative cases of surgical exploration. Results of emergency surgery in 74 cases, 2 cases of non-surgical treatment. 46 cases were positive, accounting for 62.2%, and 28 cases were negative (37.8%). Conclusions Hematemesis, blood in the stool, dyspnea, bile or intestinal fluid exudation in wounds, diffuse peritonitis and shock suggest abdominal organ injury. Emergency surgery is needed. Abdominal wall is penetrated, the omentum or part of the small intestine prolapse is not the absolute indications for emergency surgical exploration